One of the most common hurdles of the holiday season is how to control sugar cravings. While this hits home the hardest with my diabetic patients, it by all means applies to every single one of us.

Most health advice sets an unattainable goal, which often leads to an “all-or-nothing mentality”. This can be devastating to someone making the gradual changes to a healthy lifestyle. Let’s be realistic and talk about what really works.

How to Fight Sugar Cravings

Ok. Let me be nerdy for a second….if you don’t like the nerdy, skip to the next paragraph

Sugary treats is often treated as one of the most satisfying foods, on a physical and emotional level. Sugar lifts energy levels and alters moods quickly. This isn’t just in your head, well, actually it is…but that’s besides the point. It alters brain chemistry, by increasing your levels of serotonin and endorphins. Sugar elevates serotonin. This happens because sugar is consumed, insulin is released, and it binds with amino acids. Together, they go to the muscles and leave tryptophan, which causes it to travel to the brain and help produce serotonin. Hence, sugar makes you feel “good”.

So what do we do about it?

Here are 5 of the biggest challenges when it comes to battling sugar- and how to stop it for good.

1) Sugar is Sugar, No Matter the Form

Sugar is a sneaky devil. We make great decisions by cutting out cakes, cookies, sodas, and obvious sugar-laden habits. What we don’t realize is that sugar is hiding behind every corner. With an American diet that relies so heavily on processed foods, anything you find in the middle of that grocery aisle is a sugar bomb. EAT REAL FOOD. I always tell my clients, shop the perimeter of the stores and be very selective at picking out anything from those center grocery aisles. Even the growing fads of natural sugars (aka. agave, turbinado sugar, even honey), are causing people to neglect the fact that these are still just sugar. Now, I’m not saying avoid honey. I’m saying be aware that they are not a free pass and should still be used with great moderation. They raise blood sugar just as much as the pure white stuff. With a diet primarily based in vegetables, fruits, lean protein, and whole grains; your sugar problems will fix themselves. Don’t be fooled by branding!

2) Calorie Consumption

This is a huge problem for my clients who are dieting or insisting on calorie counting. You limit yourself earlier in the day in order to have more calories at night. The 3pm itch hits and you find yourself staring down a cupcake and rationalizing that its “ok” because you have so many calories still left over.

Breakfast and lunch, whether your counting calories or not, should always include a healthy mix of carbohydrates, protein, and fat. By limiting yourself early, your setting up for failure later.

Examples of quick meal fixes to incorporate these things include adding an egg, nuts, or protein to your oatmeal or cereal, along with some fresh fruit for some major fiber. This keeps you fuller, longer. For lunch, consider adding a protein like diced chicken or canned beans, and a healthy carb like quinoa or brown rice to go with your veggies. Not only will this make those veggies way more appealing, but it will help control cravings later in the day. Keep the healthy fat too! Adding some avocado, a little olive oil, or some seeds always helps with staying power.

3) Fasting and Floundering

We’ve all been there, no time for breakfast, just coffee and out the door. Or work is slammed, you never even stop to take a break. If you wait until your starving to eat, your going to eat the wrong things and WAY too much of them. By eating small amounts throughout the day, you fight off the craving before it even starts. I’m not nice when I get hungry, and I fixate on food until I get it. If you put a scale to it, with 1 being full/not hungry at all to 10 being belligerent and hungry (haha yeah it happens), I always aim to eat at about a 6 or 7. I never, ever let myself lose control of something as simple as hunger because you can’t fight it. This allows me to make better decisions and avoid the pleasure/guilt cycle.

4) Sleep sabotage

Sleep is so important. We all know losing sleep can lead to serious weight gain and increased calorie intake (remember that nasty little hormone, cortisol). When we sleep, our body repairs. This helps our body control appetite and keep our metabolism moving while we are awake. When you don’t have enough sleep, your body overreacts and tells you to eat more sweet stuff to feel better and wake up. Get plenty of sleep, ‘nuff said.

5) Swap the Habit

Remember how I said we love sugar because it releases serotonin and endorphins? Yeah, well so does physical activity. Train your mind that you can substitute your sugar craving for activity. Want a snickers? Call a friend and head out shopping or to the gym. Can’t stop thinking about the donuts sitting on the counter at work? Take a 15 minute, brisk walk. Come back and be surprised when the donut really doesn’t matter (mostly because somebody else already ate it).

Today has me in a complete work mode, and it has been a very…very…slow start. My computer (my beloved Toshiba from pre-pharmacy school days) finally kicked the bucket on Sunday. The screen went completely black and the processor just gave out. It figures that as soon as I get a little momentum with blog posts, etc. that I would have tech issues! Today was my first day off since then, Garth picked out a computer from Best Buy ( I picked up this one) that would meet all my business/blogging/personal needs. I picked it up and proceeded to transfer all my files and get it set up to work. By the time I sat down to actually start on some posts and patient charts, It was already after 2pm. This might be setting the worst example ever, but I ordered a pizza, wrote off my workout for the day, and now I’m hunkered down, ready to get completely caught up for the week (cross our fingers ).

This week, I had every intention of doing post giving everyone an update on where the business is headed and how my CDE is progressing. This is as good an opportunity as any! I’m fully integrated into the community here in Fredericksburg since moving in July. It’s been such a blessing to move farther away from the city, closer to my job and surrounded by friends and a positive environment. I’m expanding my services into the Richmond market and am hoping to also expand into remote consultations through this blog. With a combination of Washington Metro, Richmond, and everything in between, I should be able to build a decent client base!

I am scheduled to take my final CDE (certified diabetes educator) exam in the late spring and I have completely finished all my experience hours. In addition to this exam, I will also be sitting for my ACE Health Coach exam as a added bonus to my patients seeking extra diet and fitness help.

Interested in personal or group diabetes education? Contact my at rxforwellnessdc@gmail.com. I am available for private consultation, group consultation for private practices, and curriculum development! I look forward to hearing from you!

One of my favorite things about my blog is getting the opportunity to share with you my very favorite things. Sometimes, these are items that help me to live a happier, healthier, simpler life (aka what my blog is all about). Other times, they are programs or ideas that I really feel I can get behind. As you guys know, I am really in to diabetes. I mean…really in to it I can’t wait to get my CDE so that I am able to help people specifically meet their diabetes goals. It’s a very important goal of my own! That’s why I feel the need to take a few lines and tell you about the American Diabetes Challenge!

“America’s Diabetes Challenge: Get to Your Goals” is an educational program from Merck and the American Diabetes Association urging people with type 2 diabetes to work with their doctor to set and reach their individual A1C goal. The program also helps people with type 2 diabetes learn if they are at risk for hypoglycemia (low blood sugar) and how they can work to reduce that risk. Friends and caregivers of those with diabetes are encouraged to challenge and help their friends and family reach their A1C goals and to support them through lifestyle changes to reach these goals.

Serious complications of type 2 diabetes; such as diabetic ulcers and amputations, diabetic neuropathy, and diabetic retinopathy can all be avoided by setting and meeting individual goals that follow the ABCs of diabetes-A for A1C, B for blood pressure, and C for cholesterol. These three important goals decrease complications, and decrease risks for major events, such as heart attacks and stroke.

2) Set goals, make a plan, and learn about managing both high and low blood glucose

3) Stick to the plan, and check in with your provider.

Are you interested in taking the challenge? Need someone to hold you accountable and help you reach your goals? Contact me to today! RXforWellnessDC would LOVE to help you reach these goals and lead a happier, healthier life! Take the challenge today!

Creating a plan for how diabetes will be managed at school should be a team effort that includes school staff, families, and health care providers. It is critical that this be documented and on file for all institutions coming in contact with the child. The Diabetes Medical Management Plan (DMMP) or care order, is the foundation for the development of all school-based care plans.

What is a Diabetes Medical Management Plan?

Parents should put full priority on getting their child’s completed and signed Diabetes Medical Management Plan from their child’s diabetes care provider. This can be completed by the child’s physician, CDE, or other care provider. As collaborative care continues, it could be a combination of all health care professionals to create the best , and most unique, plan for the child. They should then give the DMMP to their child’s school to implement and carry out.

Every child’s diabetes will be handled very differently. Many children have not been transitioned to the recommneded insulin pens, they still use the traditional syringe and vial or have insulin pumps. Some students are still newly diagnosed and need varying or less amounts of insulin (aka the Honeymoon Period). Others are going through horomonal changes which is constantly toying with blood glucose levels, causing instability. Not to mention children are dealing wDiabetes Medical Management Plan for School Staffith issues of peer pressure and acceptance, and are unable to always make clear decisions based on their state of health. For this reason, orders for school care need to be individualized for each student.

Below is an example presented by the American Diabetes Association and National Diabetes Education Program for a comprehensive DMMP. Examine and make unique for your child with diabetes.

Omada Health recently (well..kinda) launched Prevent Now, an online version of the Diabetes Prevention Program (DPP). The landmark NIH-funded DPP study found that moderate weight loss (around 5% of body weight) and lifestyle changes could reduce the risk of developing type 2 diabetes by 58%. 58%! That’s huge! Participants in Omada Health’s 16-week Prevent program receive one-on-one support from a professional health coach via phone and messaging, as well as online courses to guide them through the DPP curriculum. Prevent also uses social networking to bring together people with similar struggles and circumstances. These small groups then support each other as they follow Prevent’s four-phase program, which entails changing participants’ food habits; increasing their activity and exercise levels; preparing to face the challenges that might otherwise cause participants to fall back into unhealthy habits; and then sustaining their new, healthier choices long-term. Prevent also incorporates health data tracking through scales and pedometers as included parts of the program.

A recent pilot study of 230 people found that Prevent participants lost an average of 14 pounds, or 6.4% of their body weight, and 72% of participants remained in the program for the full 16 weeks, which is a very strong retention rate for a this type of program. Prevent currently costs $120 per month for the four-month course ($480 total). This price is for individual consumers, and Omada Health is also working on a commercial version that will be offered through employers. Omada is also in talks with insurers and health systems to secure reimbursement for the program – we believe this is a question of “when,” not “if.” Check out Prevent, but if you are interested in one on one counseling, with more personalized services, feel free to contact me to discuss RXforWellnessDC’s menu of diabetes management services!

Studies have shown that exercise can be as effective as some medications when it comes to beating type 2 diabetes. Every little bit of activity helps. During exercise, glucose (sugar) gets driven out of the bloodstream and into the muscles for fuel. If your body has more muscle, it can store a lot more blood sugar. Plus, there’s the weight loss that comes with an active lifestyle: dropping a few (or more) pounds improves your insulin response, further lowering glucose levels. While most exercises will help, the following are a few activities that research has shown to be most effective:

Interval Training

How Often? >Once week for 30 minutes
Any type of aerobic activity helps cells absorb sugar, but interval training (alternating high-intensity bursts with low/moderate-intensity recovery) accomplishes a lot in a short amount of time. One study found that as few as 10 minutes of intense interval training per workout is enough to lower glucose levels by 13% for up to 24 hours in people with type 2 diabetes. Challenge yourself for a few minutes, even if it is as little as walking as fast as possible for a few blocks. The smallest change can have a huge effect on glucose control.

Strength Training

How Often? >twice a week for 20 minutes
Strength training gives you significantly more control over blood sugar levels than you get with cardio alone. One study found that exercisers who did a combo of cardio and strength training had a nearly 1% lower hemoglobin A1C value, compared with non-exercisers–better than the aerobic-only group or the strength-only subjects. (Need to apply this? a 1% drop in A1C means the risk of cardiovascular disease drops by up to 20% and the risk of eye or kidney disease by 40%.)Body-weight exercises such as squats, lunges, push-ups, and dips will stimulate plenty of muscle growth. Try to incorporate 1-2 sets of each move, choosing from exercises that target the whole body.

Keep Moving

How Often? Constantly!
Most people spend at least two-thirds of their day completely sedentary. Even if you are sticking to a fitness regimen, getting in more basic movement during the day can drastically reduce your risk for insulin resistance, heart disease, and obesity.Use every opportunity to move more. Take the stairs, walk to lunch, or pace while on the telephone. All extra movement burns calories, which leads to better glucose control and a smaller waist line.

Moral of the story: move more and you will see amazing results. Start small and finish strong!

While Sunday is usually a relaxing, put your life back together kind of day for me, I had the opportunity through the DC chapter of the American Diabetes Association to volunteer at the annual Tour De Cure. For those of you who aren’t familiar, it’s a bike race benefiting diabetes research, and you guys know how crazy I am about diabetes!

Tons of people showed up for races ranging from 14 miles to well over 100. That is true dedication. Many drug and healthcare companies brought whole teams of people to ride and support the cause.

I spent my time at the actual ADA booth offering educational materials on nutrition, implementing physical activity, and medication adherence. I always enjoy getting a chance to educate people in such a casual and open environment. I met so many people who were either living with diabetes, had a child with the illness, or were supporting the cause because they understand the impact that diabetes is having across the world.

If you are interested in ADA events check out this website. They keep up to date on all the local events. In fact, the Fit Foodie 5K Race Weekend is June 19th-21st at the Mosaic Town Center in Fairfax. The weekend is jam-packed with celebrity chef tastings, culinary and fitness demonstrations, yoga sessions, a fitness boot camp,all led by celebrity trainers and fitness experts. The event is raising funds for the ADA and is wicked fun way to learn a few new tricks for living healthy!

Still working hard on this website, trying to get all the little kinks worked out. Look forward to a fitness-inspired post coming up! What your favorite way to get moving?